Thread: A Motivated Mo'vember. PG-13, long post.

Seems like I've been handed a reason to be a more motivated participant in the forthcoming Movember:

Low Testosterone.
(For inquiring minds: my results said 229.0, referenced against lean males up to 40 years of age with a normal of 348-1197.)

It seems the rocket scientists down in my genetic JPL have been replaced with whomever has been crunching the numbers over at the N. Korean rocket program . (Upon proofreading, note: this wasn't a racial joke, it was a poor math joke!)

I knew that my inability to grow a beard was one of the symptoms of Low T. I wonder if my T levels have always been below average for me at every given stage in life? Being a "late bloomer" is common among my family, so hitting growth spurts & other puberty changes happening later than school peers isn't a cause for concern. But in general, until recently, everything else seemed to be within tolerance, so to speak.

A bit of personal history.

When my wife and I first got together a decade ago, we basically spent the whole weekend locked in a room together. She lived about two hours north of me; and I would basically recover during the week . I moved in with her about a year later, after a policy change at the headquarters level meant I was out of a job despite good performance in the face of a stacked deck... (But that is a discussion better suited for another day . ) We didn't "get busy" with the same frequency after cohabitation began, for reasons such as working three part-time jobs & temporary living with her parents, life happens.

But my interest, and being the initiator has become less and less over the past few years. This in turn caused some frustration for SWMBO, and understandably so. I just chalked it up to "not being young & in my teens anymore". I can look back on a time in my life when the surplus of fluctuating hormones nearly drove me insane! Strong mental fortitude got me through adolescence. Anyway...

The warning signs.
(Additional details in the spoiler.)

I've always had A.D.D., but my lower self started having trouble with focus. If we took too long to segue, "he" would get bored and not want to keep doing his part, and I'd have to try & wake him back up. Well, a month or two ago, he was catatonic. So I requested an appointment with my doctor to discuss getting a blood test. That appointment was fairly brief.

Doc' said I had to get the blood drawn at 8am. My bedtime is about 5 or 6am.
Me: "In the morning? You know I work nights, right..."
Doc': "It's an insurance thing. They insist it be done around 8am, because that is when T levels are highest & the best measurements. Circadian rhythms, etc."
Me: "That's not my morning, but whatever Doc'. I guess I'll just stay up later one night, and come in when the lab opens in the morning."

A few days later, his nurse left a voicemail while I was sleeping. I returned the favor, getting a messaging service when I called back. After a week of no return call, I called one afternoon. First test confirmed low testosterone, so a second test is needed to ensure accuracy & check for other possible causes like the thyroid. A day and a half after the second test, I was awake when the nurse called. Double confirmation of Low T, and I should contact my insurance provider to get a list of covered treatments/products, then report back to the Doctor with said list.
Me: "Sooo... I don't need to schedule a followup appointment to discuss this, or anything??"
Nurse: "Nope. Just talk to your insurance company so we know what hormone replacement therapy to put you on."
Me: "Uhhh, 'kay. Thanks...?"

That can't be the end of it...

Here's the thing... I've been on this same schedule for around two years. And I've always been a night owl. I don't really buy this whole "...our bodies release chemicals at certain times of the day, regardless of our lives..." business. I'm sure there is a guy halfway around the world that works the same hours as me, but is on a day shift.

More importantly, we are not all the same! Virtually every single study doesn't even consider participants that are on anything other than a typical "9 to 5" schedule. I found a study that raised the concern of "office hours" as a restricting factor. I found one study that actually dug into the role sleep plays on our biological cycles. This study was somewhat limited in participants & duration, but was otherwise well documented & detailed. It showed sleep to be the primary reason testosterone levels peak, with the circadian timing causing a marginal increase during morning hours, even for day sleepers.

Also, I'm a little surprised my Doc' didn't refer me to an endocrinologist. I think I will ask for a referral to one, just in case. I have been doing more and more reading on Low T, over the past month. Which only adds to my hesitation about going on Hormone Replacement Therapy. Regardless, I will stop by the doctor's office this week to request a copy of my lab results. I have thus far had no reason to complain about the service my doctor provides. This on its own isn't necessarily a cause for a soured relationship. I would feel better having a deeper understanding of my personal situation.

It might be primary hypogonadism, but it might be secondary. My brief phone discussion with the nurse didn't provide any insight as to an exact cause or diagnosis.

It may not apply to my situation, but many men have been able to increase their testosterone levels through diet, exercise, and getting enough sleep. I'm fairly fit, due to a physically challenging job. I don't eat ultra healthy, but I also don't eat any junk food. I also take a multivitamin (Centrum) every day. My sleeping habits could be better, and is something I was already trying to improve.

I felt the following details might be considered "T.M.I." for some people, so it is behind the spoiler tag.

->Reveal<-

For years, I had noticed problems with the... "product" that left my reproductive factory. It looked as if the texture was more closely resembling tapioca. Gross... but because I wasn't trying to have any children yet, it was only ranked as a curiosity rather than a concern. Oh, and the only reason I really got a good look at the stuff was because of those mornings where I'd have to put on a fresh change of boxer briefs, because the clean pair I put on the night before were a mess.

I guess one thing is for sure: certainly more reason than ever to get out there and bang the drum this Movember!!!

What say you?

Sorry to read about your predicament.

LH levels will tell whether it is a testicular of pituitary gland problem. High LH: testicular problem, low LH: pituitary problem, normal LH: no problem.
If you wanna know about your fertility: get a sperm count.
Low libido isn't necessarily due to low testosterone levels.
Alcohol, other things on your mind, unhappy relationship being a few factors that come to mind.

I personally like the Mayo Clinic website: reliable information, not the B/S you find elsewhere on the www.
http://www.mayoclinic.org/diseases-c...e/ovc-20248454

Yes, that is some of the information I have come across. This is yet another rabbit hole for me to fall down. Looked at Mayo Clinic, among others.

These are just the ones I've bookmarked this week. It represents well under a third of the reading I've done. It would have been more, but some articles are just a regurgitation of the same information.

Testosterone: What's a Normal Testosterone Level in Men? | The Art of Manliness

How to Increase Testosterone Naturally | The Art of Manliness

https://en.m.wikipedia.org/wiki/Hypogonadism

https://en.m.wikipedia.org/wiki/Huma...c_gonadotropin

https://academic.oup.com/jcem/articl...0/jc.2005-0520

These articles focus mainly on (free) testosterone levels alone. LH gives you much more information as to what is going on.
In the wikipedia article it is stated clearly that there are a few problems with testosterone tests.
One more problem is that the symptoms of low testosterone are also often seen in men with normal testosterone levels. Only if after supplementation to normal levels all symptoms disappear you can conclude the symptoms are caused by a low testosterone. If not, a low testosterone was not the (only) culprit.

Or you could ignore it if you feel well otherwise. Mucho evidence on negative consequences for hormone manipulation in both men and women.

Age: 31
Gender: Male


Results

Order: TESTOSTERONE SERUM
Name: Testosterone, Serum
Date: 5/15/2017
Value: 229.00
Units:
Range: 348-1197
Comment: 5/15/2017 Adult male reference interval is based on a population of lean males up to 40 years old.

Order: ALT / SGPT
Name: ALT (SGPT)
Date: 5/25/2017
Value: 16.00
Units:
Range: 0-44

(I think you get the gist of the formatting by now, I'm not going to bother reorganizing the rest...)

Order: PROLACTIN
Name Date Value Units Range
Prolactin 5/25/2017 9.20 4.0-15.2

Order: HEMOGLOBIN AND HEMATOCRIT
Name Date Value Units Range
Hemoglobin 5/25/2017 14.80 12.6-17.7
Hematocrit 5/25/2017 44.20 37.5-51.0

Order: FSH and LH LC
Name Date Value Units Range
LH 5/25/2017 6.00 1.7-8.6
FSH 5/25/2017 4.90 1.5-12.4

Order: TESTOSTERONE SERUM
Name Date Value Units Range
Testosterone, Serum 5/25/2017 156.00 348-1197
Comment: 5/25/2017 Adult male reference interval is based on a population of lean males up to 40 years old.

Order: TSH+Free T4 LC
Name Date Value Units Range
TSH 5/25/2017 4.13 0.450-4.500
T4,Free(Direct) 5/25/2017 1.07 0.82-1.77

END OF COPY

Boy-oh-boy, this is no fun to get the formatting corrected! Copy & paste seemed like the easy way...

Well, that certainly is more comprehensive than: "The results say you have low testosterone, let us know what medicine/therapy your insurance will cover!" At least now I can use the reference materials I've gathered to gleam the source of the issue! I haven't done that yet, btw. I'm at work today, so this was put together during my breaks.

Your LH level are normal, your other pituitary hormones too.
So we really need to know your free testosterone/SHBG level. If the latter is low your bio-available/free testosterone may be normal.

Is the last bit not part of what you just referred to?...

Order: TSH+Free T4 LC
Name Date Value Units Range
TSH 5/25/2017 4.13 0.450-4.500
T4,Free(Direct) 5/25/2017 1.07 0.82-1.77

And I set an appointment with my doctor to discuss my options. I am also going to ask him to explain what my situation is. I would like a thorough understanding of it, and also want to ensure he has considered all possibilities.

I work in a bread factory, and literally sweat gallons of fluids a day for a few months in the summer, so I do not consider topical therapies to be an appropriate delivery system. I'm worried about not only sweating it off, but also must consider the risk of contaminating the product!

T4 is thyroid hormone, TSH thyroid stimulating hormone. The latter being a pituitary hormone.

Finally! Got a real answer, from the doctor appointment today...
Secondary Hypogonadism!

I am a bit relieved, to be honest. This means there are treatment options available other than Hormone Replacement Therapy!

Though my insurance provider currently does not cover it, I started HCG subcutaneous injection treatment today. A pretty low dose. $86 for a month's supply . Sadly, I will not use the entirety of my prescription before it expires, even with refrigeration. Maybe it will qualify for "special circumstances" with my insurance. I need to look into availability at retail pharmacies, as well: I got the impression that the compounding place I went through today was the only game in town for HCG.

But at least I don't have to worry about testicular atrophy, for now. Though reproduction is not currently a goal, it is something that was desired to keep as an option.